Dr. John M., cardiac electrophysiologist, cyclist, learner and of course physician blogger recently put out 6 reasons why he blogs recently at http://www.drjohnm.org/2012/01/six-reasons-why-doctors-blog/.

Over a year ago, Drs. Mark Pool, Bruce Friedman and I put together an editorial for the Journal of Pathology Informatics entitled "Ten important lessons we have learned as pathology bloggers".

However, John, Mark, Bruce and I failed to mention one important idea/lesson on why physicians blog, or perhaps more specifically on why physicians should blog and a persona motivator for me. 

No approval is necessary.  

Physicians are some, if not, the most highly regulated and controlled professionals/human beings in our society. Hospitals, practices, insurance companies, state licensing authorities, malpractice insurers, credentialing, JCAHO, FDA, CMS and a host of professional and regulatory organizations, in the case of pathology, CLIA, AABB, CAP, ACS, tumor registries, state reporting agencies, public health agencies, county/state medical societies, all have professional standards, regulations, codes of conduct, standards, good clinical business practices, good housekeeping practices, permits, memberships, inspections, needed credentials (and re-credentials), peer-reviews, etc... (This may be the longest, most gramatically incorrect sentence I have written on this blog in 5 years).  

If you do clinical research add to the list, institutional review boards, human use committees, tissue bank committee, adverse reporting requirements, standard reports due, written reports and of course the fruit of your efforts - a manuscript submission, more peer-reviews, committees and re-reviews.

If you write enough, you get invited to speak on what you have written about, expect a program committee, executive committee endorsement and more forms to provide your content to the meeting organizers and disclose any conflicts of interest in your presentation. Attendees of your talk may be required to fill out a questionaire crity appicing your presentation, style and format in order to get their necessary CME certificate to submit to their hospital credentialing, state licensing, group/practice/ employer or malpractice carrier.  This in turn affords a physician to keep his/her license, insurance and hospital priveledges only to have to get re-credentialed and obtain more CME.

Of course, this comes with the job.  Insuring the safety of the public, maintaining practice standards, high moral character, lifelong learning, contributing to the collective body of knowledge, etc... is part of what being a professional and physician means. 

I still do some peer-reviewed writing and help with program committees and agree to speak when offered the opportunity and actually enjoy the process but it can't compare with blogging for the simple fact that no pre-approval is necessary.  

No committees, boards, government agencies, regulatory bodies, etc... No spousal, team, company, policy, group, media or IRB approval.  

Of course this can create other problems, since there is no safety net and some physician bloggers, in particular, have learned this the hard way.  Without objective groups or individuals to review what you write, much like yelling "fire" in a crowded theater is not a useful manner to exercise your right to free speech (particularly if there isn't a fire) one needs to keep in mind effective blogging for the masses.  To educate, archive, connect, show humaness, display interesting information within your niche and give perspective.

Not sure how to end this but fortunately I have an article review due in a few hours, IT committee meeting to prepare for, credentials packet due, a manuscript that is overdue and disclosure forms to submit for an upcoming meeting so my approval-free time is up...